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Splanchnic artery aneurysms are rare vascular lesions with a high risk of rupture regardless of their size. Symptoms may vary from simple abdominal pain or vomiting to morbid conditions like haemorrhagic shock; however, most aneurysms are asymptomatic and difficult to diagnose. In this study, it was aimed to present the case of a 56-year-old female with a ruptured pancreaticoduodenal artery aneurysm treated by coil embolization.

Objectives Chronic total occlusion (CTO) of the EVAR graft is a rare and serious complication. Traditionally, surgical intervention with prosthetic graft replacement or bypass graft implantation is performed. However, there are limited data in endovascular era. Methods We present a case of a 68-year-old male with a history of late EVAR graft occlusion treated with multiple surgical interventions (femorofemoral crossover, extra-anatomic bypass surgery, and thrombectomy) five years ago. Color Doppler ultrasound (CDUS) and computed tomography (CT) angiography revealed thrombosis of the entire bypass graft. Endovascular recanalization and remodeling of the abdominal stent graft CTO was performed with a combination of bare stents and stent grafts. Rupture of the stent graft occurred on the right limb. A second covered stent was placed. Results At 12-month follow-up, the patient was symptom free. Color Doppler ultrasound surveillance showed patent aortic stent graft and downstream arteries. Conclusions Endovascular recanalization of aortic stent graft CTO is a viable option in patients with failed bypass graft.

AMAÇ: Bu çalışmada amaç, böbrek nakli vericilerinin renal bilgisayarlı tomografi anjiyografi (RBTA) tetkiklerinin radyasyon dozunu saptamaktadır.GEREÇ VE YÖNTEM: Etik kurul onayı retrospektif olarak alınan bu çalışmaya 3. basamak hastanede Temmuz 2017 ve Aralık 2019 tarihleri arasında çekilen RBTA tetkikleri dahil edildi. Görüntü arşivleme iletişim sisteminden, BT tetkiklerinin hacimsel BT doz indeksi (Volume CT dose index, CTDIvol) ve tarama alanı boyunca alınan doz (dose length product, DLP) değerleri hasta doz raporlarından kaydedildi. Etkin doz (ED) ve tarama uzunluğu (TU) hesaplandı.BULGULAR: RBTA çekilmiş 142 hastanın % 54 (n=76)'ü erkek, % 46 (n=66)'sı kadındı. RBTA'sı elde edilen hastaların ortalama yaşı 43,8±12,5'dir. RBTA tetkiklerinin ikinci çeyrek (ortanca) toplam tarama alanı boyunca alınan doz (DLP) ve ED değerleri sırasıyla 835 mGy.cm ve 12,5 mSv'dir. Kontrastsız, arteryel, venöz ve geç faz çekimlerin ortalama TU değerleri sırasıyla 31,4±3, 21,9±3, 32,1±4,5 ve 22,7±4,7 cm'dir.SONUÇ: Çalışmamızda RBTA tetkiklerinin radyasyon dozu parametreleri literatüre göre daha düşüktür.

OBJECTIVE. The purpose of this study was to evaluate the safety and efficacy of transhepatic pharmacomechanical thrombectomy of symptomatic acute portomesenteric venous thrombosis. MATERIALS AND ME...

Purpose To evaluate the feasibility and technical outcomes of retrograde access via occluded pedal arteries in endovascular treatment of critical limb ischemia (CLI) when the conventional antegrade approach fails. Materials and Methods One hundred fifty-one patients with CLI (age 69 y ± 10.5; 116 men) who were not surgical candidates and were treated via retrograde pedal access between January 2016 and January 2018 were evaluated retrospectively. Seventy patients in whom retrograde access was performed through occluded arteries constituted the occluded group, and 81 patients who were treated via retrograde access from patent arteries constituted the nonoccluded group. Pedal access success, lesion crossing success, angiographic success, overall technical success, and procedure-related complications were evaluated and compared between groups. Results Pedal access success (74 of 78 vs 83 of 87 attempts; P = .873) and lesion crossing success (64 of 78 vs 77 of 87 lesions; P = .340) were comparable between subgroups. Angiographic success (54 of 78 vs 77 of 87 lesions; P = .012) and overall technical success (48 of 70 vs 72 of 81 patients; P = .004) rates were lower in the occluded group. Procedure-related complications were similar between groups (P = .096). Conclusions Retrograde pedal access from occluded pedal arteries is a feasible option when an antegrade approach fails in endovascular treatment of CLI. Although it has lower technical success, its use enables angiosome-directed therapy and has the potential to improve the outcomes of the procedure.

PURPOSE: We aimed to obtain typical values for head, neck, chest, and abdominal computed tomography (CT) examinations from routine patients in 2018, and to review our data with national and international diagnostic reference levels (DRLs). METHODS: Single-phase head, neck, chest, and abdominal CT scans of adults performed in 64-slice CT in 2018 were included in this study. Radiation dose parameters of CT scans were obtained from the picture archiving and communication system of our hospital. Volumetric CT dose index (CTDI(vol)) and dose length product (DLP) values were recorded. Effective dose (ED) and scan length was calculated. A 16 cm diameter phantom is referenced for head CT, and 32 cm diameter phantom is referenced for neck, chest, and abdominal CT. Descriptive statistics of the variables were given according to the normality testing. RESULTS: Median CTDI(vol) value was 53 mGy for the head, 13.1 mGy for the neck, 8.3 mGy for the chest, and 8.6 mGy for the abdomen. Median DLP value was 988 mGy.cm for the head, 299 mGy.cm for the neck, 314 mGy.cm for the chest, and 457 mGy.cm for the abdomen. Median ED value was 2.07 mSv for the head, 1.76 mSv for the neck, 4.4 mSv for the chest, and 6.8 mSv for the abdomen. Considering national DRLs, median CTDI(vol) values of head, chest, and abdomen were lower, whereas median DLP and ED values of head and chest were higher. For the abdomen, the median DLP and ED values were lower. CONCLUSION: Overall radiation dose parameters obtained in this study points out the need for optimization of head CT examinations in our institution.

Aim: Ultrasound elastography (USE) has been found useful in differentiation between malignant and benign lesions of various tissues, such as the thyroid, breast, lymph node and prostate, however, there is limited data on the parotid gland. The aim of this study is to assess the diagnostic performance of B-mode ultrasonography (US) and USE findings in differentiating between benign and malignant parotid gland masses. A secondary goal is to evaluate results for the most frequent benign lesions. Methods: In this cross-sectional study, 57 masses in 48 patients were evaluated. 2 radiologists examined each patient. B-mode US (size, contour, skin depth, internal structures, calcification, cystic component) and USE (a semiquantitative value strain index (SI)) findings were noted. We considered each feature individually. All patients underwent fine needle aspiration cytology (FNAC) and surgical resection.Results: 50 masses were benign and 7 were malignant. Among B-mode US results, contour irregularity was found to have the highest accuracy (85.7%) in differentiating malignant lesions. When USE findings were considered, intra-observer agreement was moderate to fair and interobserver agreement was moderate. Malignant masses had mildly high SI scores. There was a wide range overlap between malignant and benign lesions. There was no statistically significant difference (P=0.422) and we could not attain a reliable SI cut-off value.Conclusion: Despite the promising results of USE in breast and thyroid lesions, conventional US findings and FNAC are still the primary diagnostic tool to evaluate parotid lesions.

Background Hepatic arterioportal fistulas are rare, abnormal, direct communications between hepatic artery and portal venous system. Treatment options shifted from surgery to endovascular interventions. Catheterization may be challenging. We report a case of a hepatic arterioportal fistula treated successfuly with Amplatzer Vascular Plug II via percutaneous transhepatic hepatic artery access after failed transfemoral approach. Case presentation 58 year old woman presented with right heart failure, kidney insufficiency and massive ascites related to portal hypertension caused by hepatic arterioportal fistula. She had a history of previous abdominal surgery. Colour Doppler ultrasound and computed tomography revealed a giant portal vein aneurysm related to large hepatic areterioportal fistula. Endovascular treatment was planned. Catheterization of the hepatic artery could not be realized due to severe tortuosity and angulation of the celiac artery and its branches. Access to the hepatic artery was obtained directly via percutaneous transhepatic route and fistula site was embolized with Amplatzer Vascular Plug II and coils. Immediate thrombosis of the aneurysm sac and draining portal vein was observed. Patients clinical status improved dramatically. Conclusion Transcatheter embolization is the first choice of the treatment of hepatic arterioportal fistulas but the type of the therapy should be tailored to the patient and interventional radiologist should decide the access site depending on his own experience if the routine endovascular access can not be obtained.

AIM To determine the prevalence of open and closed posterior superior iliac spine (PSIS) using lower abdominal computed tomography (CT) examinations. MATERIAL AND METHODS Eight hundred and fifty (M/F:464/386) adult patients who underwent lower abdominal CT between January 2018 and December 2018 were evaluated retrospectively. One radiologist reviewed CT images of patient pelvises to assess the presence of open and closed PSIS. RESULTS The mean age of all patients was 52.7 ± 18 years. Of the 850 patients, 522 (61.5%) had open PSIS, while 328 (38.5%) had closed PSIS. The distribution of open and closed PSIS by gender was 57.5% and 42.5% in males and 66% and 34% in females, respectively. CONCLUSION Overall, open PSIS is more common than closed PSIS. The closed PSIS is seen more often in males than in females. If an anteromedial sacral (S)-1 screw direction is chosen for posterior fusion with rod-screw fixation, it is essential to obtain CT images for evaluation of PSIS.

Purpose We aimed to determine the safety and effectiveness of percutaneous endobiliary radiofrequency ablation of malignant biliary obstructions with a temperature-controlled radiofrequency ablation device. Methods In this single center retrospective study, a total of 62 consecutive patients with malignant biliary obstruction were evaluated. Thirty patients who underwent endobiliary radiofrequency ablation with metallic stent placement were in the study group and 32 patients who underwent only metallic stenting were in the control group. Outcomes of this study were technical success, complications related to the procedure, stent patency, and overall survival. Results All procedures were technically successful in both groups. There was no procedure-related mortality in either group. Procedural complication rates were similar between the groups. Although statistically not significant, the only two major complications (hemobilia requiring endovascular treatment) were in the control group. Median primary stent patency was significantly longer in the study group than in the control group (223 days vs. 158 days; P = 0.016). Median survival rates were also longer in the study group (246 days vs. 198 days; P = 0.004). Conclusion Percutaneous endobiliary radiofrequency ablation is safe and feasible with this novel radiofrequency ablation device in patients with malignant biliary obstruction. Percutaneous endobiliary radiofrequency ablation has a potential to improve both stent patency and survival.

Objective: This study aimed to investigate the feasibility of low-dose chest CT acquisition protocol for the imaging of COVID 19 disease or suspects of this disease in adults. Method: In this retrospective case-control study, the study group consisted of 141 patients who were imaged with low dose chest CT acquisition protocol. The control group consisted of 92 patients who were imaged with standard protocol. Anteroposterior and lateral diameters of chest, effective diameter and scan length, qualitative and quantitative noise levels, volumetric CT dose index (CTDIvol), dose length product (DLP), and size-specific dose estimations were compared between groups. Results: Radiation dose reduction by nearly 90% (CTDIvol and DLP values 1.06 mGy and 40.3 mGy.cm vs. 8.07 mGy and 330 mGy.cm, respectively; p < 0.001) was achieved with the use of low-dose acquisition chest CT protocol. Despite higher image noise with low-dose acquisition protocol, no significant effect on diagnostic confidence was encountered. Cardiac and diaphragm movement-related artifacts were similar in both groups (p=0.275). Interobserver agreement was very good in terms of diagnostic confidence assessment. Conclusion: For the imaging of COVID-19 pneumonia or suspects of this disease in adults, lowdose chest CT acquisition protocol provides remarkable radiation dose reduction without adversely affecting image quality and diagnostic confidence.

WOS: 000534371300023 PubMed: 32200216 Objectives: To investigate the effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) and to compare low-frequency versus high-frequency STN-DBS on hemodynamic parameters of the middle cerebral artery between patients with advanced Parkinson's disease and age-sex matched healthy controls. Patients and Methods: Eighteen patients with advanced Parkinson's disease (PD) with bilateral STN-DBS and 18 control subjects underwent Transcranial Doppler Ultrasound (TCDU) were included in the study. The hemodynamic parameters including blood flow velocity (FV), pulsatility index (PI) and, resistance index (RI) of the right middle cerebral artery (MCA) were measured and compared during the phases using TCDU. The first DBS-off, the second low-frequency DBS of 60 Hz, and the third high-frequency DBS of 130 Hz were compared. Results: PD patients had significantly higher MCA-PI values compared with controls (0.99 +/- 0.27 vs. 0.82 +/- 0.14) (p = 0.031). Also, the MCA-PI values were higher in the low-frequency DBS (0.94 +/- 0.14) and high-frequency DBS (0.93 +/- 0.16) than in the controls (0.82 +/- 0.14) (p = 0.022 and p = 0.041, respectively). There were no significant differences of FV and RI values among the DBS-on, DBS-off and, controls. The RI values were higher in the PD patients than in the controls, although these were not statistically significant. Also, PI values of the MCA decrease in different frequencies (60 Hz or 130 Hz). Conclusion: The results of this study showed that MCA-PI values are higher in advanced PD compared with controls. These indices indicate that MCA resistances and impedances are increased in advanced PD. Low- or high-frequency DBS treatment have beneficial effect to reduce high PI in advanced PD patients.

OBJECTIVE: The aim of this study is to evaluate the scan length variability and the effect of the scan length on radiation dose parameters in consecutive thoracic and abdominal CT examinations.MATERIAL AND METHODS: Patients who underwent consecutive thoracic (n = 85) and abdominal CT (n = 57) examinations between January 2018 and December 2018 were included in this study. Thirty-nine percent (n = 33) of the thoracic CT examinations and 51 % (n = 29) of the abdominal CT examinations were performed on women. CT radiation dose parameters were obtained retrospectively from picture archiving communications system. Volume CT dose index (CTDIvol) and dose length product (DLP) values were recorded from the patient protocols. Effective dose (ED) and scan length (SL) were calculated. Consecutive thoracic and abdominal CT examinations were divided into two groups (first examination and second examination), and CT radiation dose parameters and SL were evaluated.RESULTS: The mean age of patients in both thoracic and abdominal CT groups were 58±16 and 51±16 years old, respectively. There was no statistical difference between consecutive CT examinations in the relevant regions in terms of DLP and ED values (p> 0.05). CTDIvol were similar between consecutive examinations in the thoracic CT group (p=0.724), whereas there was significant difference between consecutive examinations in the abdominal CT group in terms of CTDIvol (p=0.042). The mean differences of SL in CT examinations were 3.3±2.6 cm for thoracic CT group and 3.1±2.5 cm for abdominal CT group. There was no significant difference in both consecutive thoracic and abdominal CT examinations in terms of SL (p> 0.05).CONCLUSIONS: In consecutive thoracic and abdominal CT examinations, there was no difference in terms of SL that can affect DLP and ED. Although there is no difference in terms of SL between consecutive thoracic and abdominal CT examinations, SL must be adjusted as short as possible since it will not cause any loss in the diagnostic information in the region of interest., AMAÇ: Bu çalışma ile amacımız ardışık toraks ve abdomen BT tetkiklerinde tarama uzunluğu değişkenliğini ve tarama uzunluğunun radyasyon dozu parametreleri üzerine etkisini değerlendirmektir.GEREÇ VE YÖNTEM: Merkezimizde, Ocak 2018 ve Aralık 2018 tarihleri arasında aynı hastaya ait ardışık toraks (n=85) ve abdomen BT (n=57) tetkikleri çalışmaya dahil edildi. Toraks BT tetkiklerinin % 39 (n=33)'u, abdomen BT tetkiklerinin % 51 (n=29)'i kadındı. BT radyasyon dozu parametreleri görüntü arşivleme iletişim sisteminden (picture archiving communications system, PACS) retrospektif elde edildi. Hacimsel BT doz indeksi (Volume CT dose index, CTDIvol) ve doz uzunluk çarpımı (dose length product, DLP) değerleri hasta protokolünden kaydedildi. Etkin doz (ED) ve tarama uzunluğu (TU) hesaplandı. Ardışık toraks ve abdomen BT tetkikleri kendi içinde (ilk tetkik ve ikinci tetkik olmak üzere) iki gruba ayrıldı, ve BT radyasyon dozu parametreleri ile TU değerlendirildi.BULGULAR: Toraks ve abdomen BT'si elde edilen hastaların ortalama yaşı sırasıyla 58±16 ve 51±16'dır. Her iki tetkik bölgesinde ardışık BT tetkikleri arasında DLP ve ED değerleri arasında istatiksel fark saptanmadı (p>0,05). Ardışık tetkikler arasında CTDIvol değeri açısından toraks BT grubunda anlamlı fark bulunmazken (p=0,724), abdomen BT grubunda anlamlı fark göstermektedir (P=0,042). Tarama uzunluğunun tetkikler arasındaki ortalama farkı toraks BT için 3,3 ± 2,6 cm, abdomen BT için 3,1 ± 2,5 cm olarak hesaplandı. Her iki tetkik bölgesinde tarama uzunluğu ardışık tetkikler arasında anlamlı farklılık göstermemektedir (p>0,05).SONUÇ: Ardışık toraks ve abdomen BT tetkiklerinde, tarama uzunluğu açısından DLP ve ED'ye etki edecek bir farklılık saptanmadı. Ardışık tetkiklerde TU açısından fark saptanmamasına rağmen, BT çekimlerinde TU taranan anatomik bölgede tanısal bilgi kaybına neden olmayacak en kısa şekilde ayarlanmalıdır.

OBJECTIVE. Metallic stenting of malignant biliary strictures is the preferred method of palliation, because most patients present when the condition is inoperable. Most metallic stents, however, are occluded 6-8 months after deployment. Intraductal radiofrequency ablation has been used in previous studies to improve stent patency. The purpose of this study was to assess a single-center experience with percutaneous intraductal microwave ablation of malignant biliary strictures. MATERIALS AND METHODS. In this retrospective case series study, data on 12 patients with malignant biliary obstruction who underwent percutaneous intraductal microwave ablation followed by metallic stenting were evaluated. Ablation procedures were performed with generator frequencies of 902-928 MHz, power set at 6-10 W, and ablation time of 60-90 seconds in a temperature-controlled manner with target temperature set at 80°C. RESULTS. Causes of malignant biliary obstruction were pancreatic carcinoma in four patients, gastric antrum carcinoma in three, cholangiocarcinoma in two, metastasis in two, and gallbladder carcinoma in one patient. Percutaneous intraductal microwave ablation and metallic stenting were performed successfully in all patients. There was no procedural mortality or major complication. The most common minor complication was abdominal pain. Biliary decompression was achieved in all patients at the end of the first month. The mean follow-up time was 9.4 months. The median primary stent patency period was 231 days. There were two stent occlusions due to sludge formation, and two patients died during follow-up. CONCLUSION. Percutaneous intraductal microwave ablation of malignant biliary strictures is safe and feasible. Prospective randomized controlled studies with long-term results are warranted to determine the effectiveness of this technique in lengthening the stent patency period.

In this prospective study, we aimed to investigate the presence and evolution of cerebellar cognitive affective syndrome in a cohort of isolated cerebellar stroke with no known cognitive or psychiatric impairment. We tried to distinguish the unconfounded effect of cerebellar lesions on neuropsychological processing.After a meticulous exclusion procedure based on possible confounders, we recruited 14 patients and 13 age-matched healthy controls to the study, prospectively. All of the patients had a detailed initial neuropsychological assessment at the first week and a follow-up assessment at the 4th month after stroke.The prevalence of cognitive or behavioral-affective abnormalities in our cohort were 86% and 64% respectively. The patients exhibited mild and transient affective-behavioral abnormalities except for depressive symptoms that persisted in the subacute stage. They scored lower in general cognitive performance as revealed by mini mental test (p=0.001). Memory, executive functions, attention and working memory, central processing speed, and linguistic abilities were impaired (p0.001; p=0.001; p=0.007; p=0.05; p0.001 respectively). Improvement was evident only in memory domain of the cognitive functions in the subacute stage. Cognitive impairment was more likely with a medial or posterolateral infarct (p=0.014). Behavioral-affective abnormalities were not associated with a specific location in our cohort. Age seemed to negatively correlate with the recovery in general cognitive performance on the follow-up.These findings show that acute denervation of cerebellocortical projections leads to mild affective-behavioral abnormalities, and full-blown cerebellar cognitive affective syndrome is rare. However, cognition was significantly affected after an acute cerebellar infarct even in a previously healthy, non-demented pure population.

Purpose To evaluate the safety, effectiveness, and outcomes of endovascular recanalization of chronic total occlusion (CTO) of the superficial femoral artery (SFA) in patients with critical limb ischemia (CLI) after failed surgical bypass graft. Methods Endovascular recanalization of SFA CTO was performed for 26 consecutive CLI patients with failed bypass grafts from 2016 to 2020. Patient demographics, bypass and lesion characteristics, procedural data, technical, and clinical outcomes were evaluated. Results The technical success rate was 96.2% (25/26). Retrograde arterial access was used in 16 (61.6%) patients. Additional tibial and iliac angioplasty was performed in 15 and 2 patients, respectively. Fifteen complications occurred in 10 patients, including thrombosis, embolism, vessel rupture, dissection, arteriovenous fistula, and pseudoaneurysm. Pain relief and wound healing were achieved in 22 patients. The primary, assisted primary, and secondary patency rates were 95.5%, 100%, and 100% at 6 months, 81.8%, 95.5%, and 100% at 12 months, and 76.7%, 82.7%, and 87.5% at 24 months, respectively. By univariate analysis, hyperlipidemia (hazard ratio = 7.82; 95% CI: 1.27–48.04, P = .026) was found to be the only significant risk factor related to primary patency loss. Amputation-free survival and limb salvage rates were 100% and 100% at 6 months, 100% and 100% at 12 months, and 87.1% and 93.8% at 24 months, respectively. Conclusions Endovascular recanalization of SFA CTO in CLI patients with graft failures is effective with high technical success rates. Acceptable limb salvage and amputation-free survival rates make this technique a reasonable alternative to repeat surgery for high-risk patients.

Oil-based contrast medium agents (Iofendylate) are cleared from cerebrospinal fluid very slowly. But it may remain within the tissues of the central nervous system. These substances, which were used for purposes such as myelography, cisternography, and ventriculography approximately 70 years ago and were replaced by water-soluble agents after thirty years, can rarely be detected incidentally. In this report, by presenting the intracranial radiopacities seen in 2 patients, it is aimed to increase awareness that these myeloid residues, which are rarely seen in panoramic radiography, can be diagnosed by clinicians.

Renal artery aneurysms (RAAs) are rare, and exist in approximately 1% of the general population (Henke et al. 2001). RAAs can be detected as an incidental finding by various imaging examinations pe...

Aim: To evaluate prevalence of cerebral arterial variations in Turkish population and association of the variations with cerebral aneurysmsMaterials and Methods: Digital subtraction angiography of 640 consecutive patients between January 2011-December 2013 were evaluated retrospectively. Patients with aneurysms were compared with patients without aneurysm to determine the effect of variations. Comparisons were made using Chi square or Fisher exact test for categorical variables and Student's t test or Mann Whitney U test for continuous variables.Results: The most common variation in the anterior circulation was hypoplasia of anterior cerebral artery A1 segment and the most common variation in the posterior circulation was fetal origin of the posterior cerebral artery. Hypoplasia and aplasia of the anterior cerebral artery A1 segment was significantly more frequent in patients with anterior communicating artery aneurysms than the control group (p:0.001). Prevalence of azygos anterior cerebral artery variation was higher in distal anterior cerebral artery aneurysms than the control group (p 0.001). There was no association between bihemispheric anterior cerebral artery and anterior communicating artery aneurysms (p = 0.453). Similarly, no significant association of fetal origin of posterior cerebral artery with posterior communicating artery aneurysms was found (p = 0.133). Conclusion: Prevalence of cerebral arterial variations in this study were compatible with literature. Some variations may play a role in development of aneurysms by alterations in hemodynamics and increasing shear wall stress. Further larger studies are needed to clarify the relation between variations in cerebrovascular structure and aneurysm formation.

HSA immobilized poly(2-hydroxyethylmethacrylate), HSA-P[HEMA], cryogel monolith was examined as an alternative sorbent to be used in hemoperfusion columns for bilirubin removal from serum. The cryogel monolith synthesis was performed by free radical polymerization using MBAA as crosslinker, APS and TEMED as redox pair. Cyanogen bromide (CNBr) was used as a matrix-activating agent for the preparation of immobilized cryogels. Control cryogel monolith, P[HEMA], and HSA-P[HEMA] were characterized by swelling test, SEM images, porosity and surface area measurements, and blood compatibility tests. Activation and immobilization processes were optimized. The removal of bilirubin from plasma samples overloaded with bilirubin was performed using P[HEMA] cryogel monoliths containing different amounts of immobilized HSA in continuous mode. Several factors affecting adsorption capacity of the matrix such as incubation time, HSA concentration, bilirubin concentration in plasma and temperature were analysed. The maximum bilirubin removal from plasma was 25.4 mg/g at 37.5 °C. The desorption agent was 0.1 M NaOH and 1.0 M NaCl containing solution. The reusability was tested for 10 consecutive adsorption–desorption cycles. The adsorption isotherm models and kinetics of process were also studied.

Objectives. The aim was to determine the prevalence of aortic arch variations in 881 patients who underwent neck CT angiography for various reasons. Material and Methods. 881 patients were included in the study who had undergone neck CT angiography between 2010 and 2013. Results. Of 881 patients, 770 (87.4%) patients with classic branching pattern of the aortic arch (AA) were observed. Variations in branching pattern were seen in 111 (12.6%) patients. The most common variation was the origination of the left common carotid artery (LCCA) from the brachiocephalic trunk (BCT). This pattern was observed in 64 (7.2%) cases. In 25 (2.8%) cases, the left vertebral artery (LVA) originated directly from the AA between the origin of the LCCA and left subclavian artery (SCA). 17 (1.9%) cases had aberrant right subclavian artery. Three (0.3%) cases showed right aortic arch. Two cases had right aortic arch with aberrant left subclavian artery. Conclusions. Variations in the branching pattern of the AA are not rare. Head and neck surgeons and interventional radiologists should be aware of aortic arch variations. CTA is a reliable imaging method for demonstrating anatomical features and variations of the AA.

Using sonographic findings to test the diagnostic accuracy of impingement versus tendon palpation tests in Neer stage I and II subacromial impingement syndrome cases and examine their clinical potential.Neer and Hawkins impingement tests and rotator cuff tendon palpation tests followed by bilateral shoulder sonography were conducted on 69 patients with a clinical diagnosis of unilateral subacromial impingement.The Neer and Hawkins tests had 74 and 62 % accuracy (sensitivity 80 and 67 %, and specificity 52 and 47 %, respectively) in comparison to 79 and 62 % accuracy rates for supraspinatus and biceps tendon palpation tests (sensitivity 92 and 41 %, and specificity 41 and 48 %, respectively). Overall, the palpation tests scored better than impingement tests in the diagnosis of Neer stage I and II subacromial impingement syndrome. No tendinosis or tear was noted in patients with negative findings in the supraspinatus palpation tests (sensitivity 100 %, specificity 21 %).Palpation tests for supraspinatus and biceps tendons have a slightly higher accuracy than the impingement tests, and if tenderness does not exist then supraspinatus tendinopathy can be ruled out. These findings warrant the use of palpation tests in a routine physical examination for tendinopathy.I.

he patellar tendon (PT) is the most commonly injured anatomical region in athletes who are engaged in sports that require jumping, such as volleyball, basketball, or running (1). The diagnosis of PT injuries is often based on clinical findings; however, the use of imag-ing of the PT has increased, especially using ultrasonography (US) (2). Unfortunately, the results of imaging modalities (e.g., magnetic reso-nance imaging [MRI] and US) are ambiguous for PT injuries, but are often used during the examinations to exclude other causes and to assess the severity of the injury (1, 3). In addition to the other mechanisms that may explain these clinically inconsistent imaging findings, inac-curacies in the measurements of imaging and of pain may have contrib-uted to these findings (1, 4).During US, the tendon thickness, internal structure, and vasculariza-tion are often the examined parameters. The thickness measurements are performed in the transverse and longitudinal planes in the majority of studies (3, 5–7); however, this method does not take into account that the tendon has a variable, non-homogenous thickness throughout its length. The PT is conic proximally, with a wider and thinner shape, (7) and tapers distally to a narrower and thicker end, with a slight poste-rior bulge (8). In addition, variation in the tendon shape and thickness exists between individuals. Therefore, the institution of cross-sectional area measurements of the thickness during US exams may provide more information about the PT.The present study aimed to examine the contribution of the PT cross-sectional area measurements using PT imaging in junior volleyball players and non-players compared with thickness alone. The present study also aimed to determine the intra-observer compliance level of reproducibility.Materials and methodsTwo separate groups of volunteers of the same age and gender were included in the present study. The first group consisted of 60 female volleyball players, and the second group consisted of 60 female seden-tary individuals. Both of the groups of females were secondary school students. Written informed consent was obtained from all of the partici-pants and their families. The ethics committee of the second author’s institution approved the study design.